Patient-reported outcome measures focusing on the esthetics of implant-compared to tooth-supported single crowns—A systematic review and meta-analysis

Objectives: To report a summary of published patient-reported esthetic outcome measures (PROMs) of implant-supported single crowns (SCs) compared with those of tooth-supported SCs. Materials and Methods: Cochrane, Medline (PubMed), and EMBASE database search was performed by three reviewers on reports with patient-reported esthetic outcomes of tooth- and implant-supported SCs. Clinical studies with at least 12 months of mean follow-up period and a minimum of 10 patients, and English, French, or German reports were included. To compare the subgroups, for aggregate-level data, random-effects meta-regression was used. Results: Two thousand fifteen titles were identified (initial search) and screened independently concluding 53 full-text articles to include in data extraction. Twenty-two studies with 29 study cohorts were included. Patients were satisfied with the esthetics of implant- and tooth- supported crowns Mean visual analogue scale (VAS) value from the PROMs data of 1270 implant-supported SCs evaluated by 1051 patients was 89.6% (80.0%–94.1%). The mean VAS value of patients (n = 201), who evaluated the esthetic outcome of 486 tooth-supported SCs was 94.4% (92.3%–96.0%). VAS scores of patients regarding their perception of esthetics did not show any difference among different crown materials or type of implant used. The patients' perception of esthetics focusing on SC had a tendency to be higher when the crowns were supported by teeth, however, no statistical difference was found when compared with implant-supported crowns (p = 0.067). Conclusions: Patient perception of esthetics in SCs was not affected by the type of support, crown material, implant, and presence of provisional crown for both implant- and tooth-supported SCs. Clinical Significance: Despite that patient's expectations are increasing overall Patients are satisfied with with esthetic outcome of implant- and tooth-supported crowns.